Background/Purpose: Surrogate markers of subclinical atherosclerosis and cardiovascular (CV) mortality such as carotid plaques (CP), arterial stiffness (AS) and carotid intima-media thickness (c-IMT), have been studied by carotid ultrasound (US) examination. In most studies done before, the results have shown an increased prevalence of CP and high values of c-IMT associated to greater CV risks. The same happens with the pulse wave velocity (PWV), which has become the gold standard to determine AS.

Our aim was to compare the prevalence of CP, PWV and c-IMT measurements between patients with moderate- severe psoriasis and the general population.

Methods: A cross-sectional study that included 40 patients with moderate- severe psoriasis (PASI>10, BAS>10 %), that fulfilled definitions for initiating treatment with a biological agent according to the Clinical Practice guidelines and 40 age-, sex- and traditional CV risk factors- matched healthy control subjects. Psoriatic arthritis (PsA) was present in 11 of 40 patients. Patients with history of CV events, diabetes mellitus, and chronic kidney disease or body max index> 35 were excluded. US was performed in the common carotid by a MyLab 70 scanner (Esaote; Genoa, Italy), QAS-RF and Q-IMT Maastricht (Holland). The results were obtained according to the Manheim Consensus Conference criteria. Statistical analysis: Qualitative data were expressed as number and percentages and quantitative data as mean (SD). Student’s t test or Mann-Whitney U were used to compare continuous variables, as appropriate. Chi2 test or Fisher test were used for qualitative variables.

Results: The main data of the patients are summarized in the TABLE. It is important to highlight that the study was based on a young population (mean age <40 years). Thus, the two groups did not present significant differences regarding the classic CV risks factors and other parameters studied, except for high sensitivity C -reactive protein (hsCRP).

As expected given the age of the group, CV risk measured by SCORE was low (0%) in most patients, with a mean of 0.2 (in the plaque psoriasis group) and 0.15 in the control group. No patient had a high-very high CV risk as measured by SCORE (≥ 5%). Patients with psoriasis had a long-standing disease (17.05 ± 11.63 years). The presence of carotid plaques was found in a total of 10 patients with plaque psoriasis (25%), 5 of them had bilateral plaques) and one in the control group (2.5%) without bilateral plaques), p <0.003. Even if patients with psoriasis had a higher PWV (6.33 m/sec) and c-IMT (0.579 mm) compared to the control group (6.13 m/sec and 0.549 mm), the difference was not significant (p = 0.72 and p = 0.17). It could be explained by the age of the study population and the sample size.

Conclusion: Moderate- severe psoriasis is associated with increased prevalence of CP, but PWV and c-IMT shows no differences.

TABLE

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/increased-prevalence-of-subclinical-atherosclerosis-in-moderate-severe-plaque-psoriasis-patients/